NPI age
19 years
Enumerated 2006-10-10
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 334688YX5G | MEDICARE GROUP NUMBER PROVIDER NUMBER |
| 01 | 0035ZE | BCBS |
| 01 (TX) | M5494 | STATE LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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